Dental Caries Prevention Technique: Buffalo Fluoride Laser Odontoplasty (BFLO)

Objectives: Dental caries result from acid-mediated demineralization of tooth structure by cariogenic bacteria metabolizing fermentable carbohydrates in oral environment. This study examined two discrete laser applications to conservatively recontour occlusal surface complexity and increase fluoride incorporation.
Methods: Deidentified extracted human teeth (UB IRB protocol (# 00001193) were treated in two different phases. Er,Cr:YSGG dental laser (First phase) was used at various settings to treat occlusal surfaces; microcomputed tomographic imaging and functional fluorescent dye retention assay following simulated mechanical brushing were performed to assess surface complexity. Silver Diamine Fluoride varnish (Second phase) was used with different laser wavelengths on samples; analyzed for acid demineralization in Lactic Acid (10.2 M) for five days at 37 °C. Colorimetric assays (Arsenazo and Malachite Green) were performed to assess demineralization using spectrophotometer. Further validation was performed using ultrastructural techniques - Fourier Transfer Infrared Microscopy (FTIR), Differential Scanning calorimetry and Thermogravimetric Analysis (DSC-TGA), Small angle X-ray scattering (SAXS), and elemental analysis (Laser-Induced Breakdown Spectroscopy (LIBS)).
Results: Laser odontoplasty significantly reduced surface complexity and increased self-cleansing occlusal areas (n = 18, p less than0.05). The SDF-658 nm laser samples (658 nm at 30 mW/cm² for 54 sec at 1.62 J/cm², 3 p.J/cm²) significantly (n = 2, p less than 0.05) reduced acid demineralization compared to SDF alone. DSC-TGA analysis of laser-SDF samples exhibited reduction in weight loss and variation in temperature flow compared to the control. SAXS analysis showed larger, elongated, and polydisperse crystals in SDF-laser samples as compared to SDF. LIBS analysis showed about 40% increase in fluoride content in SDF-laser samples compared to SDF alone.
Conclusions: The Buffalo fluoride laser Odontoplasty (BFLO) technique demonstrates efficacy in minimizing occlusal retentive areas and enhancing resistance to acid demineralization. This approach shows promise for clinical and public health dentistry, particularly in childhood caries prevention.